Human Ethology Newsletter
Volume 5, Issue 15, September 1990

A Heart for Nurses?

Most biologists, at least ethologists, are familiar with K. Lorenz's famous "Kindchenschema." Among other functions, it protects small, helpless children from aggressive acts of their caretakers who may be tired and nervous from endless crying, feeding, cleaning, listening, watching, and so forth.
A second group of people is similarly vulnerable: the elderly, or very old people, who indicate helplessness, e.g., by using a stick (as a third leg, according to the riddle of Oedipus). They exhibit distinct features, variable in grade and combination, yet representing a definite "life-phase phenotype" (see Appendix). Can they also expect by their habitus alone to elicit a smile, to facilitate body contact and caressing behavior? Or does the hypothesis apply that the (very) aged do not enjoy such a "sympathy guarantor" because their appearance in our phylogeny is so recent?
Data from paleoanthropology and prehistory seem to indicate that individual life spans seldom exceeded 30 years. Historians describe an almost exponential increase in longevity over the past century. Biology adds that individuals having contributed their share to rearing offspring (including grandchildren?) may even reduce resources for their progeny by "going on" beyond this 30-year period.
Thus, if old age was not selected for by evolution and its phenotype therefore remains "unknown," natural proneness to help beyond familiarity (read "kin") will be improbable. Even worse, do not certain features of otherwise healthy, elderly individuals (e.g., spotted skin, sensory weakening) happen to overlap symptoms of disease or dysfunction? This might further promote distance-keeping behavior by others.
Now my reasons for addressing the HEN Forum: I did my physician's residency training in a hospital where in April 1989 three nurses admitted to having killed more than 40 patients by the misuse of care (drowning by "oral rinsing," overdosing with hypnotics or insulin). Murder - yes - and the Austrian mass media made it the issue of the month; yet, the following circumstances are cause for reflection:
- the average age of the victims exceeded 80 years;
- the nurses, who lacked diplomas, worked at the hospital for years, at low   wages;
- for the most part the patients who were killed were "troublemakers" during    the night.
Now, what is really known about attitudes toward the elderly during nonkin, nonfriend, professionally dictated, cumulative, prolonged, mostly unidirectional interactions? Four biological grandparents are the greatest number an individual can have, but rarely they are together in one place, and virtually never do they all rely exclusively on that individual's presence, company, help…………

Appendix: Outline of an "old-age scheme" (incomplete)

1. Morphology
·the face (most important landscape of human life, first object,
 permanent stage for personal encounters)
·skull: visible as a result of fat reduction, eyes sunken in sockets
·hair: increased and bristly (nose, eyebrows, ears) or reduced (head)
·disproportion: ear and nose cartilage continues to grow during life
·hands: bony, conspicuous joints, veins, and nails
·skin: dry, scaly, slack, spots (some growing, becoming elevated,
 multiplicating  (these "signs of age" are so typical that the first title for
 the paper was  "growing points in gerontology"), blotches, warts,
 wrinkles, furrows
·arms and legs: thin with conspicuous joints; muscles flabby
 erect posture (symbol of humankind): height reduction, exaggerated
 spinal curvatures
·disproportion: torso shortened (limbs retain their length)

2. Behavior (everyday activities, expression of will and emotion)
·in general: slowed, rigid or shaky (tremor, insecurity, loss of power)
·eyes: tendency to become fixed or furtive
·arms and legs: mobility impaired (hip, knee, shoulder stiffness)
·gait: inelastic, unvarying, "heavy", walking aids
·reaching: tremor of arms, but firm grip, clenching
·eating: bowed sitting, shaky hold an utensils, impaired chewing
·urinating, defecation: troublesome

3. Communication (speech as carrier for intellect, personality, social  exchange)
·rhythm: slow, pausing, repetitious, monotonous
·topic selectivity: food, intestines, feces, family, neighbors, doctors,  materialism (accommodations, money, jewels)
·orientation difficulties: time, place, people, memory and sensory
 impairment
·emotion: propensity toward high pitch, loudness, imperiousness,  aggressiveness, intolerance and/or defensiveness, lamentation,
 whimpering and/or detachedness: humming, "whistling".